Bariatric surgery in California is three-and-a-half-times more expensive than in Maryland, according to a new HealthGrades study that also found wide variations in the quality of outcomes at hospitals that perform the elective weight-loss procedures.
The HealthGrades Fourth Annual Bariatric Surgery Trends in American Hospitals Study, released today, found that California was, on average, the most expensive of the 19 states evaluated for bariatric surgery, with an average charge per procedure of $52,224. Maryland was the least expensive with an average charge per procedure of $14,577.
Consistent with other studies, HealthGrades also found that high bariatric surgery volumes correlate with better outcomes. Hospitals with more than 375 bariatric cases in three years had a 32% lower risk of in-patient complications than lower-volume hospitals with less than 75 cases over three years.
Golden, CO-based HealthGrades evaluated 153,355 bariatric procedures performed during 2005-2007 in 19 states that provide all-payer information. The study analyzed outcomes for the most common gastric bypass procedures, such as less-invasive laparoscopic procedures including gastric banding, malabsorbtive procedures, and combined malabsorbtive/restrictive procedures.
"Due to the wide gap in quality we see among bariatric surgery programs, we encourage patients to carefully evaluate the volume and in-hospital outcomes of the bariatric program they are considering," says Rick May, MD, a senior physician consultant with HealthGrades and a co-author of the study.
The study also found that:
- Bariatric surgery patients treated at top-rated hospitals have, on average a 67% lower chance of experiencing serious complications compared to patients who receive treatment at poorly rated hospitals.
- Patients having surgery at five-star hospitals spent, on average, more than half a day less in the hospital (2.15 days) compared to patients having surgery in one-star hospitals (2.72 days).
- Of the 19 states studied, more than 61% of all procedures were performed in five states: New York, Texas, Pennsylvania, California, and Florida.
- Patients in Vermont, on average, spent the most time in the hospital (3.26 days), while patients in Nevada, on average, spent the least amount of time in the hospital (1.56 days).
- The number of inpatient procedures during the study years 2005 through 2007 showed no significant increase, but an increasing percentage of surgeries are being performed outpatient.
- More Center of Excellence bariatric surgery programs earned a five-star rating (29.5%) than non-COE programs (12.3%).
- Laparospcopic bariatric surgery procedures account for 79% of all procedures, up from 54% in last year's study.
- Patients had a three times lower in-hospital death rate associated with a bariatric surgery if they had it performed at a five-star hospital versus a one-star hospital.
The states included in the study were: Arizona, California, Florida, Iowa, Maine, Maryland, Massachusetts, Nevada, New Jersey, New York, Oregon, Pennsylvania, Rhode Island, Texas, Utah, Vermont, Virginia, Washington, and Wisconsin.